- AdventHealth (Tampa, FL)
- …Center. **The ro** **le you'll contribute:** The Inpatient Coding Quality Auditor , under general supervision of the Inpatient Operations Manager, is responsible ... the daily auditing of records. The Inpatient Coding Quality Auditor works in collaboration with the Manager to ensure...applicable to AdventHealth West Florida Division and requirements of Medicare and payor specifications. . Assign DRGs on chart… more
- Nuvance Health (Danbury, CT)
- …audits, reporting, complaint coding issues etc. 5.Research CMS and NGS Medicare regulations, guidelines, bulletins, and other publications for impact to professional ... services.Monitor listservs such as CMS, Medicare , NGS, AAPC etc. and third-party payers for coding...or CCS-P AAPC or AHIMA required* *Certified Professional Medical Auditor (CPMA) or Certified Documentation Expert Outpatient (CDEO) required*… more
- Guthrie (Sayre, PA)
- Summary: A senior level compliance coding auditor conducting assessments in accordance with The Guthrie Clinic's policies and procedures and accepted guidelines for ... insurance regulations as well as The Guthrie Clinic policies, as applicable, Medicare , Medicaid, and LCD (Local Coverage Determinations), and NCD (National Coverage… more
- WTW (Chicago, IL)
- **Description** As a Lead Auditor you will apply your audit, project management and client management skills to lead client audits. You will serve as the team leader ... claims administration knowledge, including experience with medical, dental, mental health and Medicare + Detailed knowledge of ICD-10 and CPT codes and coding… more
- Waystar (Atlanta, GA)
- **ABOUT THIS POSITION** We are looking for a Revenue Integrity DRG Auditor who has a comprehensive understanding of hospital Revenue Cycle Management. Significant ... hospitals and health systems, and is connected to over 5K commercial and Medicaid/ Medicare payers. We are deeply committed to living out our organizational values:… more
- St. Luke's University Health Network (Allentown, PA)
- …of a patient's ability to pay for health care. The Network Provider Services Auditor performs audits as part of the Documentation and Coding Compliance Program for ... in coding and documentation State and Federal regulatory requirements including Medicare , Medicaid and third-party payers as well as strong written/verbal… more
- Sharp HealthCare (San Diego, CA)
- …+ 2 years' experience working as an HCC risk adjustment coding auditor . + Experience with medical billing, medical terminology, understanding of medical ... of care following coding rules and regulations.Applies understanding of Medicare , Medi-Cal, and/or ACA and other payor guidelines.Identifies documentation… more
- Highmark Health (Helena, MT)
- …system entities in response to external coding audits conducted by the Medicare Administrative Contractor, the RAC, MIC, ZPIC, etc. Determine appeal action, prepare ... Professional Coder (CPC), Certified Outpatient Coder (COC), Certified Professional Medical Auditor (CPMA) + 5 years with hospital or physician coding and/or… more
- Datavant (Denver, CO)
- …educational and life experiences to realize our bold vision for healthcare. As an Auditor , HCC Risk Adjustment Coder, you will review medical records to identify and ... + Proficient in ICD-10 coding. + Experienced in HCC coding across Medicare , commercial, and Medicaid sectors. + In-depth knowledge of medical terminology,… more
- Centers Plan for Healthy Living (Staten Island, NY)
- …and training by monitoring the field staff on a monthly basis. The Trainer/ Auditor will provide oversight of the field staff. He/she will bring back observations ... paced environment + Managed long term care knowledge + Medicaid knowledge + Medicare knowledge SCOPE INFORMATION # Direct Reports: Training and Development Manager -… more